فهرست مطالب

Journal of Education and Health Promotion
Volume:8 Issue: 4, Apr 2018

  • تاریخ انتشار: 1397/04/12
  • تعداد عناوین: 13
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  • Patrícia Petromilli Nordi Sasso Garcia, Danielle Wajngarten, Juliana Alvares Duarte Bonini Campos Page 44
    CONTEXT

    The ergonomic posture protocol is extremely important for the maintenance of occupational health in dentistry. The lack of compliance with this protocol results in a high risk of developing musculoskeletal disorders.

    AIMS

    This study developed a direct observation method for the evaluation of dental student compliance with ergonomic posture protocol.

    SUBJECTS AND METHODS

    The method is named compliance assessment of dental ergonomic posture requirements (CADEP). During the development of the method, 14 items were elaborated considering the theory of dental ergonomics. Each item should be classified as appropriate, partially appropriate, or inappropriate. After evaluation, all item values should be added, and the final score expressed as the percent of compliance with correct postures, with a score range of 0%–100%. STATISTICAL ANALYSIS USED: The reliability of CADEP was assessed through intra‑ and interobserver reproducibility. For the CADEP application, 73 senior year students from the undergraduate course in dentistry were evaluated. The intra‑ and interexaminer concordance was estimated using the intraclass correlation coefficient (ρ). A descriptive statistical analysis was performed.

    RESULTS

    The reproducibility of evaluator 1 (ρ =0.90; confidence interval [CI] 95%: 0.83–0.94), evaluator 2 (ρ = 0.83; CI 95%: 0.70–0.90), the interexaminer in the first evaluation (ρ = 0.81; CI 95%:0.67–0.89), and in the second one (ρ = 0.76; CI 95%: 0.59–0.87) was classified as good. In the analysis of the compliance, it was verified that moderate compliance was the most prevalent among the evaluated students (65.6%, CI 95%: 60.3%–70.7%).

    CONCLUSIONS

    CADEP was valid and reliable for the assessment of dentistry students’ compliance regarding ergonomic posture requirements.

    Keywords: Compliance, dental education, dental ergonomics, dental student, occupational health
  • Zohreh Ghorbani, Seyed Morteza Shamshirgaran, Samad Ghaffari, Parvin Sarbakhsh, Farzad Najafipou, Nayyereh Aminisani Page 45
    BACKGROUND AND OBJECTIVE

    There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older.

    MATERIALS AND METHODS

    The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health‑related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence.

    RESULTS

    A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09–1.15), gender (ORadj = 1.65 95% CI: 1.08–2.51), obesity ORadj = 2.51 (1.40–4.88), waist‑to‑hip ratio (WHR) (ORadj = 1.70 (1.05–2.75), and comorbidities (ORadj = 2.51 (1.72–3.66) were independent predictors of hypertension.

    CONCLUSION

    Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high‑risk groups according to age, gender, and disease profile are recommended.

    Keywords: Awareness, control, PERSIAN cohort, hypertension, prevalence, treatment
  • Faezeh Eslamipour, Kamal Heydari, Marzieh Ghaiour, Hoda Salehi Page 46
    INTRODUCTION

    The current study aims to study people’s access to oral and dental health‑care services and their satisfaction with the services provided to them.

    MATERIALS AND METHODS

    A descriptive study with multi‑stage sampling was conducted on 1360 people aged 16–64 years residing in Isfahan city, Iran. The required data were collected by a questionnaire which comprised of three main parts: demographic characteristics, patients’ access to oral and dental health‑care services and its barriers and participants’ satisfaction with access to services. Data were analyzed by SPSS statistical software.

    RESULTS

    The results showed 40% of participants reported an average level for oral health, and 82% of them did not have any problems regarding access to dental care facilities. The main causes of their dissatisfaction were high cost of services (60%) and insufficient health insurance coverage (40%). About 73% reported that they had to spend 30 min or less to access to a dental health‑care facility. In addition, 50% of participants were satisfied with the provided services. The main reported reasons for referring to dentists were oral and dental problems (69%) and regular check‑ups (15%). There was no significant relationship between participants’ gender, education level, insurance coverage, and access to dental health‑care centers (P > 0.05).

    CONCLUSION

    Most participants were satisfied with access to dental healthcare, but they were dissatisfied with the costs and inadequate insurance coverage. About half of the participants were satisfied with the services provided to them, and the highest level of satisfaction was reported for easy access to health‑care centers.

    Keywords: Dental care, personal satisfaction, persons
  • Kenneth D Royal, Suzanne A Hunt, Luke B Borst, Mathew Gerard Page 47
    OBJECTIVE

    The objective of this study was to better understand veterinary medical students’ sleep hygiene and identify the extent to which sleep hygiene behaviors may result in consequences (either positive or negative) for students. SAMPLE: A total of 187 doctor of veterinary medicine (DVM) program students at a large College of Veterinary Medicine in the United States.

    METHODS

    The Epworth Sleep Scale and Daytime Sleepiness Scale were administered to 393 students enrolled in the DVM program.

    RESULTS

    About 55.1% of students reported <7 h of sleep per night, 28.9% reported having trouble sleeping, and 50.3% reported feeling sleepy all day. With respect to sleep quality, 5.3% described it as excellent, 52.4% as good, 34.2% as fair, and 8.0% as poor.

    CONCLUSIONS

    A significant percentage of veterinary medical students exhibit poor sleep hygiene habits that may be detrimental to both their health and academic endeavors.

    Keywords: College students, health professions, medical education, quality of life, sleep, sleepiness, veterinary medicine, wellness
  • Siamak Mohebi, Mahmoud Parham, Gholamreza Sharifirad, Zabihollah Gharlipour, Abolfazl Mohammadbeigi, Fatemeh Rajati Page 48
    BACKGROUND

    Social support is one of the most effective factors on the diabetic self‑care. This study aimed to assess social support and its relationship to self‑care in type 2 diabetic patients in Qom, Iran. STUDY DESIGN: A cross‑sectional study was conducted on 325 diabetics attending the Diabetes Mellitus Association.

    METHODS

    Patients who meet inclusion and exclusion criteria were selected using random sampling method. Data were collected by the Summary of Diabetes Self‑Care Activities and Multidimensional Scale of Perceived Social Support, with hemoglobin A1C test. Data were analyzed using descriptive statistics and independent t‑test, analysis of variance, Pearson correlation, and linear regression test, using 0.05 as the critical significance level, provided by SPSS software.

    RESULTS

    The mean and standard deviation of self‑care and social support scores were 4.31 ± 2.7 and 50.32 ± 11.09, respectively. The mean level of glycosylated hemoglobin (HbA1C) of patients was 7.54. There was a significant difference between mean score of self‑care behaviors and social support according to gender and marital status (P < 0.05). The regression analysis showed that disease duration was the only variable which had a significant effect on the level of HbA1C (P < 0.001). Pearson correlation coefficient indicated that self‑care and social support significantly correlated (r = 0.489, P > 0.001) and also predictive power of social support was 0.28. Self‑care was significantly better in diabetics with HbA1C ≤7%. Patients who had higher HbA1C felt less, but not significant, social support.

    CONCLUSIONS

    This study indicated the relationship between social support and self‑care behaviors in type 2 diabetic patients. Interventions that focus on improving the social support and self‑care of diabetic control may be more effective in improving glycemic control.

    Keywords: Cross‑sectional studies, diabetes mellitus, social support, type 2, self‑care
  • Mitra Reyhani, Ashraf Kazemi, Mahrokh Keshvari, Ziba Farajzadegan Page 49
    BACKGROUND

    Securing a healthy sexual relationship during middle‑agedness would cause new needs and expectations in women, considering the special changes of this period. Therefore, the present study was conducted to determine the sexual needs of middle‑aged women.

    METHODS

    The present study was a qualitative study with content analysis approach. Participants were 15 middle‑aged women; their expectations and needs about sexual relationship were gathered using in‑depth semi‑structured interviews. Data were analyzed using Graneheim and Lundman inductive content analysis.

    RESULTS

    The main themes that were appeared in the present study included “the need for information” with subcategories of “the need for information about physiologic changes” and “information about psychological changes;” “the need for sympathy” with subcategories of “the need for receiving appropriate feedback” and “appropriate space for expressing the emotions;” “the need for changing social norms” with subcategories of “accepting middle‑agedness by the society” and “the need for changing the concept of femininity;” and finally “the need for repairing the sexual relationship” with subcategories of “solutions for solving sexual problems” and “paying attention to the new aspects of sexual relationship.”

    CONCLUSIONS

    Results showed that middle‑aged women have various sexual needs and expectations and paying attention to these needs and expectations could affect the improvement of the sexual and mental health of middle‑aged women and their families.

    Keywords: Expectations, middle age, needs, qualitative study, sexual relationship
  • Nimisha D Desai, Paragkumar D Chavda Page 50
    BACKGROUND

    Worldwide, studies show negative attitude among medical students toward psychiatry and mental illness. The knowledge of the attitude and awareness of the undergraduate medical students toward psychiatry, mental health, and psychiatric disorders are most important as they are going to be involved in the care of these patients either directly or indirectly during the later years of their careers.

    AIM

    This study aims to assess attitude toward psychiatry and mental illness among undergraduate medical students.

    METHODOLOGY

    The responses of 67 medical students from the 6th semester (third professional year) batch who completed their 2‑week clinical posting of psychiatry in 4th semester (i.e., second professional year) were collected using validated questionnaires, attitude towards mental illness (AMI), and attitude towards psychiatry (ATP) that assessed their attitudes to psychiatry and mental illness. Double data entry and validation were done using EpiData and analysis using Epi Info software.

    RESULTS

    Median AMI score was 54 (out of maximum 100) showing a neutral AMI. Median ATP score was 82 (out of maximum 150) also showing a neutral ATP. The theme‑wise analysis showed that the attitude of students toward psychiatrist and psychiatry branch was relatively better compared to their AMI.

    CONCLUSION

    Undergraduate students have a neutral attitude to psychiatry and mental illness. More efforts are needed to change the attitude to favorable side.

    Keywords: Attitude, medical students, mental illness, psychiatry
  • Saeed Khosrawi, Hadis Ramezanian, Roya Mollabashi Page 51
    CONTEXT

     Physical medicine and rehabilitation (PMR) is a specialized clinical field of musculoskeletal diseases and physical impairment that is unknown for most of the medical students.

    AIMS

    This study aimed to assess medical students’ attitude and knowledge toward PMR and its role in the diagnosis and treatment of musculoskeletal diseases. SETTING AND DESIGN: This cross‑sectional study was done on 175 medical students of Isfahan University of Medical Sciences from 2015 to 2016. Sample population was selected by random sampling among 350 students.

    MATERIALS AND METHODS

    Participants were evaluated by a research‑made questionnaire with confirmed validity and reliability. This questionnaire included 36 questions divided in four parts including demographic data, knowledge, attitude, and performance ranking. STATISTICAL ANALYSIS USED: Data were analyzed using SPSS 20. Statistical test for quantitative and qualitative variables was carried out by mean ± standard deviation and percentage or number, respectively. For analyzing variables, Student’s t‑test and Chi‑square test were used.

    RESULTS

    In this study, 150 medical students with a mean age of 24.48 ± 1.48 years participated of which 40% of them were male. The mean score of Student’s knowledge about PMR and its role in diagnosis and treatment of disorders was 5.16 ± 1.90, and 91.3% had low level of knowledge. The mean score of student’s attitude toward PMR and its role in the diagnosis and treatment of musculoskeletal problems was 3.33 ± 0.46, and 69.3% had attitude level above the average. Evaluation of student’s performance showed that when they manage patients with musculoskeletal problems as general physician, they refer the patients to physiatrists at the first step if it is necessary.

    CONCLUSION

    Understanding the factors influencing the attitudes and knowledge of medical students is prime to help establishing the roles, providing proper facilities, carrying out successful planning to train expert physicians and create a motivated environment in medical schools.

    Keywords: Attitude, diagnosis, knowledge, musculoskeletal diseases, physical medicine, rehabilitation, treatment
  • Maryam Mirzaee Jirdehi, Fariba Asgari, Rasool Tabari, Ehsan Kazemnejad Leyli Page 52
    BACKGROUND

    Achievement of productivity and improvement of quality in the educational system is the effective, influential factors for countries development. Academic achievement is the main objective of the training program and the most important concerns of teachers, education officials, and university Student’s families. Self‑esteem is one of the factors affecting student academic achievement. This study is aimed to investigate the relationship between self‑esteem and academic achievement in Medical Sciences students of in 2014–2015.

    SUBJECTS AND METHODS

    This is a descriptive–correlational study. In this study, 537 university students were selected using random stratified sampling method from Guilan University of Medical Sciences in 2014–2015. Data were collected using the standard self‑esteem questionnaire of Cooper Smith consisting of four elements (general, social, familial, and educational) and a demographic questionnaire. Data were analyzed using SPSS software version 21 and descriptive statistics such as Spearman correlation and Logistic Regression.

    RESULTS

    The results indicated a significant relationship between grade point average and educational self‑esteem (P = 0.002, r = 0.135) and global self‑esteem (P = 0.02, r = 0.102). There was also a significant relationship between composite Index educational status and general self‑esteem (P = 0.019, r = 0.102) and academic achievement (P = 0.007, r = 0.116) and global self‑esteem (P = 0.020, r = 0.102).

    CONCLUSIONS

    According to the results, the highest mean score of self‑esteem was related to the familial element, and the lowest average was in terms of social self‑esteem, therefore, given the importance and necessity of self‑esteem in academic achievement, strengthening of all aspects of self‑esteem is suggested.

    Keywords: Academic achievement, self – esteem, student
  • Mohammadhossein Arjmandnia, Mahsa Besharati, Sajad Rezvan Page 53
    CONTEXT

    Congenital heart disease (CHD) is an important cause of death during the 1st year of life and includes a special group of cardiac diseases that exist from birth. These conditions arise due to the abnormal development of an embryo’s normal structures.

    AIMS

    A case–control study was conducted to investigate the determinant factors leading to CHD.

    MATERIALS AND METHODS

    All newborns who have been diagnosed with CHD upon echocardiography in 2013 were considered as cases. The number of samples required was randomly selected from the newborns who lacked CHD on cardiography. The mothers of both groups were handed the questionnaires. STATISTICAL ANALYSIS USED: SPSS 23 was employed to analyze the data.

    RESULTS

    A statistically significant association was seen between CHD and a positive family history (FH) (P < 0.001), consanguinity (P < 0.001), maternal diabetes (P = 0.004), the use of antiepileptics during the first 45 days of gestation (P = 0.002), and the mother’s education status (P > 0.001). No significant association was observed between CHD in the newborn and the age below 20 and above 35 years and (P = 0.11), maternal body mass index (BMI) (P = 0.44), smoking during the first 45 days of gestation (P = 0.017), and maternal rheumatologic diseases (P = 0.4).

    CONCLUSIONS

    Newborns are at a greater risk of having CHD born from mothers with a FH of CHD, from consanguineous marriages, history of diabetes, antiepileptic use, and lack of folic acid use. However, no significant associations were found between newborn CHD and maternal age, BMI, or cigarette smoking.

    Keywords: Case–control, congenital heart disease, risk factors affecting congenital heart disease
  • Mahshid Givi, Masoumeh Sadeghi, Mohammad Garakyaraghi, Ameneh Eshghinezhad, Mahin Moeini, Zahra Ghasempour Page 54
    BACKGROUND

    Prehypertension is one of the cardiovascular disease predicators. Management of prehypertension is an appropriate objective for clinicians in a wide range of medical centers. Massage therapy is primarily nonpharmacological treatment that is used to control blood pressure (BP). This study intends to investigate the long‑term effect of massage therapy on BP in prehypertensive women.

    METHODS

    This was a single‑blind clinical trial study conducted on 50 prehypertensive women who referred to Sedigheh Tahereh Cardiovascular Center, during 6 months in 2009. Participants were selected by simple random sampling and were divided into control and intervention groups. The test group (25 patients) received massage for 10–15 min, three times a week for 10 sessions, and the control group (25 patients) was relaxed in the same environment but with no massage. Their BP was measured before and after each session and 72 h and 2 weeks after finishing the massage therapy. Analyzing the data was done using descriptive and inferential statistical methods (Chi‑square, Mann–Whitney, paired t‑test, and Student’s t‑test) through SPSS software version 18 and a significant level was considered as P < 0.05.

    RESULTS

    The results indicated that the mean systolic BP (SBP) and diastolic BP (DBP) in the massage group were significantly lower in comparison with the control group (P < 0.001). Evaluation of durability of the massage effects on BP also indicated that 72 h after finishing the study, still there was a significant difference between the test and control groups in SBP and DBP (P < 0.001), but after 2 weeks, there was not a significant difference in SBP and DBP (P > 0.05) between the two groups.

    CONCLUSIONS

    Although massage therapy seems to be a safe, effective, applicable, and cost‑effective intervention to control BP of prehypertensive women, its effects do not persist for a long time.

    Keywords: Blood pressure, long‑term effect, massage therapy, prehypertension
  • Ali Safari Moradabadi, Azin Alavi, Asiyeh Pormehr Yabandeh, Tasnim Eghbal Eftekhaari, Sakineh Dadipoor Page 55
    BACKGROUND

    Mortality and disability rates were reported to be respectively 2‑3 and 5‑10 times higher in C‑sections compared to Vaginal delivery.

    OBJECTIVES

    This study was aimed to explore the factors involved in selecting the birth type among primiparous women.

    METHODS

    The present cross‑sectional research was conducted on 220 primiparous women, who visited the health‑care centers of Bandar Abbas. They were recruited in their first trimester of pregnancy with a simple randomized clustering method. Data were collected in a researcher‑designed questionnaire. Its validity was confirmed by a panel of experts and reliability was tested and approved through the test–retest method. Mean, standard deviation, independent sample t‑test, and Chi‑squared tests for data analysis were done by SPSS 16. P < 0.05 was considered statistically significant.

    RESULTS

    The mean age of the participants was 27.40 ± 6.07 years. The main barriers to the choice of vaginal delivery were the fear of pain and fear of vaginal area tears and ruptures, fear of injury to fetus, and doctor’s recommendation. A statistically significant correlation was observed between the age, education, employment, income, awareness, and the reasons for preferring surgical childbirth.

    CONCLUSIONS

    To reduce the rate of unnecessary cesarean sections (C‑section), the following recommendations are suggested: Reducing fear of pain in expectant mothers, modifying wrong beliefs about the culture of natural childbirth, increasing awareness of fewer adverse effects of vaginal delivery including the vaginal tears if the mother abides by all midwife(s) instructions during the delivery procedure, providing educational courses for the necessary movements during the delivery, decreasing surgeons’ payment for C‑section, and increasing payment for natural childbirth and implementing barriers for optional delivery to reduce the C‑section.

    Keywords: Birth type, cesarean section, Iran, primiparous women, vaginal delivery
  • Raksha Goyal, Neeta Deshmukh Page 56